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HomeMy WebLinkAboutPitkin.EH.273503300044 (2017)Pitkin County Environmental Health Department f t N Onsite Wastewater Treatment System (OWTS) *1,' USE PERMIT APPLICATION 76 Service Center Rd * Aspen, CO 81611 http://pitkincounty.com/248/Wastewater-Treatment Application for Continued Use of an Existing OWTS Parcel ID# (available from the Pitkin County Assessor's Office 2735 033 00 044 970-920-5160 or at http://pitkinassessor.org/assessor/search.asp Purpose of Use Permit: PROPERTY TRANSACTION ❑REMODEL/ Property Address: 860 W. Buttermilk Road Lot: Block: Filing: Subdivision: M/B Buttermilk Residences: Other # of Bedrooms: 3 fixtures/uses: Property Owner(s)*: Email Address: MARGOLIS ALLAN B WE MARITAL TRUST Owner's Mailing Address: City, State, Zip: 198 Union Blvd Lakewood CO 180228 Home Phone: Business = *Contact information must be provided for the owner signing this application. Primary Contact Person/Applicant (if not owner): Jason Hodges Company: Mason Morse Contact/Applicant Mailing Address: City, State, Zip: 290 Hwy 133 Carbondale CO 81623 Cell Phone: Business Phone: (843) 367-5101 704-3225 Fax Number: Email Address: jhodges@masonmorse.com Indicate Preferred Method of Payment Check I ■ Credit/Debit Cash Licensed Systems Inspector: Phone Number: Email Address: Fax Number: Carla Ostberg (970) 309-5259 jhodges@masonmorse.com Mailing Address: City, State Zip: 33 Four Wheel Drive Road lCarbondale 1CO 181623 PLEASE READ BEFORE SIGNING: I certify that the above information is complete and accurate and that I have provided complete and accurate information in all of the documents included in my application package. I acknowledge that this department may revoke any permit I am issued if my application is found to contain any inaccurate, false, or misleading information. signed by Cada Otberg ly r1 a ^� St bo g Datea12017.1 06 09:04: 6S 06'01 Please allow 3-5 business days for processing of Use Permits, 10/6/17 Effective Date 1/12/2017 Owner's Name: Address: Parcel Number: Inspection Date: Pitkin County Systems Inspector License Number: QUESTIONS FOR PROPERTY OWNER PRIOR TO INSPECTION: Is the home currently occupied? YES NO If NO, how long has the home been vacant? How many bedrooms are in the home? RECORDS: Were system records available from Pitkin County? YES NO If YES: Permit number: ___________ Date of Final Approval: _________ # of bedrooms permitted: ___________ Was an as-built drawing available? YES NO Is the as-built drawing accurate? YES NO If NO: SITE CONDITIONS: Proper grading, no evidence of erosion?PASS FAIL Improper vegetative cover? NO YES Evidence of compaction such as heavy machinery or livestock? NO YES Improper discharges such as straight pipes?PASS FAIL Evidence of high ground water? NO YES Snow cover present? NO YES Any question marked FAIL will require correction before an OWTS Use permit is issued. If secondary treatment is used, who is the maintenance provider? Complete a drawing of the system on last page of this form as accurately as possible. Email: Inspector's Name: Business Name: A copy of this inspection report will be remitted to Pitkin County Environmental Health Department by the Licensed Systems Inspector within 60 days of the inspection regardless of whether the system passes or fails. Onsite Wastewater Treatment Systems (OWTS) Use Permit Inspection Form Inspection form for continued use of an existing OWTS Website: Pitkin County Environmental Health Department 76 Service Center Rd, Aspen, CO 81611 Phone: 970-920-5070 Fax: 970-920-5374 Phone Number Page 1 http://pitkincounty.com/248/Wastewater-Treatment Margolis, Allan B N-E Martial Trust 860 W. Buttermilk Road Aspen, CO 2735 033 00 044 9/20/17 Carla Ostberg CBO Inc. (970) 309-5259 carla.ostberg@gmail.com 017 n 1 year 3 n/a n 11/15/73 3 n n n n n n n n Effective Date 1/12/2017 Permit 720134 (final approval 11/15/73) and ISDS Permit 84024 (final approval 7/30/84) possibly fill on top of STA TANK: Tank capacity gallons gallons gallons Tank material # of compartments Date of last pumping Lids/risers in good condition Risers to grade Riser height Riser condition/watertightness Inlet sanitary T/baffle Outlet sanitary T/baffle Effluent filter (if part of design) Condition of tank material Tank was pumped for inspection If YES, list the pumping company If NO, when was the last pumping Scum level (1st compartment) inches inches inches Sludge level (1st compartment) inches inches inches Scum level (2nd compartment) inches inches inches Sludge level (2nd compartment) inches inches inches Backflow (if pumped) Midtank baffle Watertightness PUMPS/DOSING SIPHONS: Is a pump or dosing siphon present? YES NO If YES, is the pump/dosing siphon functioning properly?PASS FAIL Does the pump/wiring/dosing siphon appear to be in good condition?PASS FAIL Is the high water alarm working, both visible and audible?PASS FAIL SECONDARY TREATMENT: Is a secondary treatment unit present? YES NO UNKNOWN If YES, does the unit appear to be in good working condition? YES NO Does the owner have a current maintenance contract for the unit?YES NO UNKNOWN Maintenance Provider:_______________________________________Phone:________________________ ABSORBTION AREA: Effluent surfacing?PASS FAIL Evidence of past surfacing? NO YES Surface dampness? NO YES Excessive odors? NO YES Field location verified by observation ports or probing: Ports Probing Liquid in observation port? NO YES If YES, record depth: inches Distribution Box or ADV part of original design? YES NO UNKNOWN If YES, is it accessible from grade? YES NO Is it level and in good condition?PASS FAIL If there is no maintenance contract, a contract must be in place prior to occupancy of the home. A copy of the contract must be submitted to Pitkin County Environmental Health Department. Tank 1 Tank 2 Tank 3 Page 2 1,250 concrete 1 4/16 Pass Select One Select One Yes Select One Select One 3' ok Pass Select One Select One Pass Select One Select One N/A Select One Select One Pass Select One Select One No Select One Select One minimal solids in tank Select One Select One Select One Fail Select One Select One Pass Select One Select One n n n/a n n n n record drawing n Effective Date 1/12/2017 it appears this is the permitted septic tank installed in 1984 Any problems with the system that were not addressed in the inspection checklist? Please list any recommendations for the continued use of the system: Were any repairs done as a result of this inspection? NO YES If YES, please describe the repairs. Licensed Systems Inspector Signature: Additional Notes: To the best of my knowledge and training, the information collected in this inspection is accurate as of __________________, 20____. Clearly label any pictures and attach them to this form. Page 3 sewer lines possibly cast iron replace septic tank with 2-compartment tank when system is modified n September 27 1717 STA appears to be original (1973) located on steep hillside where grades may have been altered and additional fill brought in over STA Save Form Clear Form Print Form Effective Date 1/12/2017 CBO Inc. 33 Four Wheel Drive Road Carbondale, CO 81623 cell) 970-309-5259 office) 970-704-0484 carla.ostberg@gmail.com September 27, 2017 Jason Hodges jhodges@masonmorse.com Onsite Wastewater Treatment System (OWTS) Use Permit Inspection 860 West Buttermilk Road Pitkin County, Colorado Jason, As requested, CBO Inc. performed an Onsite W astewater Treatment System (OWTS) Use Permit inspection at 860 West Buttermilk Road, Aspen, Colorado on September 20, 2017. The legal description of the 5.079-acre property is as follows: Subdivision: M/B BUTTERMILK Section: 3 Township: 10 Range: 85 A PARCEL IN THE NE4SW4 & LOT 12 SEC 3-10-85 DESC BY M/B BK 447 PG 456 The permit and record drawing was provided by Pitkin County Environmental Health Department (Parcel ID #2735-033-00-044). The subject OWTS consists of one 1250-gallon, single-compartment concrete septic tank. Effluent gravity flows to a 600 square foot (10’ x 60’) pipe and gravel soil treatment area (STA). Pitkin County Health Department Permit Number 720134 documents the original system which included a ‘Cavitette’ plant and 600 square foot STA. This permit notes the system was sized to accommodate 2 bedrooms. The permit received final approval on November 15, 1973. Individual Sewage Disposal System (ISDS) Permit 84024 documents the replacement of the ‘Cavitette’ plant with a 1250-gallon Copeland Concrete septic tank. This permit notes the system was sized to accommodate 3 bedrooms. This permit received final approval on July 30, 1984. The septic tank is located to the west of the residence. We did not observe a clean out between the house and the septic tank. Both septic tank lids were accessible from grade with 3-feet of risers. There are built-in baffles on both the inlet and outlet sides of the septic tank. The septic tank was pumped a few months before the house became unoccupied. The septic tank had minimal accumulation of solids at the time of our inspection. The septic tank has only a single compartment, although the record drawing associated with ISDS Permit indicates two-compartments. The original system installation in 1973 may have been with cast iron pipes. We were unable to verify the type or condition of the sewer pipes from the house to the septic tank and septic tank to STA. Cast iron is prone to deterioration and clogging. The STA is located between the garage and the driveway. The slope of the hillside is very steep, which indicates there could be a significant amount of fill over the STA. We did not observe any inspection ports in the STA. We walked the STA and there was no evidence of surface saturation or failure at the time of our inspection. It appears from the documentation that the STA is original (1973). Given the age of the STA, there is no guarantees regarding the longevity of the STA. This evaluation is not a guarantee of future system performance. This inspection is good for one year. Recommendations: • When the system is modified, the single-compartment septic tank will need to be replaced with a two-compartment septic tank. This report and a completed OWTS Use Permit Application must be submitted to the Pitkin County Environmental Health Department. Applications may be submitted to Pitkin County Environmental Health Department electronically. The following are links to the required OWTS Use Permit Application and Checklist. Application: http://www.pitkincounty.com/DocumentCenter/Home/View/621 Application Checklist: http://www.pitkincounty.com/DocumentCenter/Home/View/620 All questions regarding permit submission can be directed to Pitkin County Environmental Health Department, 970-920-5070. Disclaimer: This inspection is intended only as an evaluation of the present condition of the OWTS based upon what was observed and the Licensed Inspector’s expertise in onsite wastewater technology. The Inspector has not been retained to warrant or guarantee the proper functioning of the system for any period of time in the future. Because of numerous factors which may affect the operation of an OWTS, as well as the inability of the Inspector to supervise or monitor the use or maintenance of this OWTS, this report shall not be construed as a warranty by the Inspector that the system will function properly for any particular prospective buyer, and the Inspector disclaims any warranty, either expressed or implied, arising from the inspection of the OWTS or this report. The evaluation does not ascertain the impact the system is having on groundwater. Please call with questions. Sincerely, Carla Ostberg, MPH, REHS NAWT Certified Inspector Certification # 11044ITC Exp. April 2018 Septic tank lids Lids in poor condition, but cover manhole Inlet baffle Outlet baffle close up of pipe (possibly cast iron) View of area of septic tank View of steep hillside between the driveway and garage (area of STA) approx. area of OWTS PITKIN COUNTYj HEALTH DEPARTMENT PERMIT NUMBER 7 2 v 13,"1 RECEIPT NUMBER Owner Ac PhonePhone # Address '7Z Contractor / Phone # Address J y Location of system ,(3£L 1 T' 1/T/'/ IM7 Lot size s % t> "E S Legal description Z.Or I.1$F C. .3 i W°~'wf / '`"'L'£ y `' F Number of bedrooms Date 6e L to Signature of owner Percolation test data Minimum recommended absorption system size Minimum recommended tank size b Permit application valid one year from date. only after lower portion is completed and si site. N't DRA i Date minutes per inch nn Y jj_j - cation to e/comme tinibToand final ttain this form at the construct CA V 17r -Mf- -beSYSvJ PC ArNw6 w c . an COLORADO DEPARTMENT OF HEALTH Water Pollution Control Division 4210 East 11th Avenue Denver, Colorado 80220 APPLICATION FOR APPROVAL OF LOCATION FOR SEPTIC TANK SYSTEMS Applicant (Owner): Mail Address: i City: A. INFORMATION REGARDING PROJECT SUBMITTED FOR REVIEW: 11 1 , -, Phone: 2 6 Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area, habitable buildings, location of potable water wells, soil percolation test holes, so)] profiles in test holes. 1. Location of Facility: County T%/J City or Town rel/t% e_b 4>>ia_Lot Size: Legal Description J y p?i- - Yh¢%f;; 2. Type of area and facility - Number of persons served: Subdivision Motel Restaurant Trailer Court Other: f;'ir t/'Ei Cl rt1 S 3. Source of domestic water: Public (name): Private: Well V' Depth Other Depth to first ground water table/NNW lVe" 4. Is facility within boundaries of City or Sanitation District: If so name: 5. Distance to nearest sewer system: Have negotiations been attempted with owner to connect: If rejected, give reason: 6. Rate of absorption in test holes in minutes per inch of crop 'n water level of r holes have been soaked for 24 hours: 7. Name, address and telephone of person who made soil absorption tests: 8. Name, address and telephone of person responsible for design of the system: 9. Est. bid opening date: Est. Completion Date: %/ %.3 Est. Protect Cost:/V, n© Date: /;"Z4 -'" Signature of Owner TEST HOLE I TEST HOLE II Reading Drop Time Reading Drop Time PERCOLATION TEST RESULTS: HOLE I Minutes per inch 1HOLE II Minutes per inch Average percolation rate• 41 6 Minutes per inch Comments on soil and/or site: Address: Signature: TEST FEE $25.00, payable in Advance ASPEN*PITKIN 2 7.3G -- D -3 3 ` ENVIRONMENTAL HEALTH DEPARTMENT INDIVIDUAL SEWAGE DISPOSAL PERMIT N0. JI 02 7 TYPE OF PERMIT: Initial Construction ( )Emergency Use ( )Repair work,(Piovious Permit i .) KAlteration of an existing sy tea, or installation (previous Permit 1 C J` ) Use Permit as a result of Sale ( )Othors ( f ISSUED TO: DATE OF ISSUE -.7-234 Owller 14LI-Az}g f COOS Home Phone d19VBusiness Phone Mailing DLAddress pQ9f r, p Q fi l 0)( X31 b2 14 Al 'e Agent ', ! `L, C70 -1 -el Phone q -27-:5V72 Addressg _01 l k c V f.PR©r/li fl T Sewage Disposal System Work to be performed by 1—% " L t y ez Q/V57' UST/U This permit valid only for premises location by tho following legal detictiptions Z SSC T-ICN,3TI 0 J LOT SIZE (' 'C r NATER SUPPLY AVERAGE PERCOLATION RATE_ / ll This Individual Sewage Disposal Permit is granted with regard to the following use:./1%_Ft''fi/F1/L%/ti/ft l Nkralh r of: Dodreoms _ J Lofts_ Garbage Disposals_ Dishwashers Clothes Washors CALCULATiX) AVERAGE DAILY WASTE LOAD GALLONS. THE NATURE OF THE SYSTEM I—N C-LUDED UNDER THIS PERMLIT: q•= .:f Tank or Treatment Units Tank Capaeity ,zLCi' _Gallon Hinla:u Mctnod of Final Disposals CJ Absorptlop Area klclo Square Feet _ Oeacription (including brand name, if any) of other equipment or appurtnancess Other Conditions or Specifications ' STAGES REQUIRING INSPECTION BY THE HEALTH DEPARTMENT: Before Excavation { )Upon completion of excavation and prior to placement of gravel { )Before covering distriF.utica system of absorption field 01) Prior to backfill of any component ( )Other, Specify:./Vo/,JF _ --- Plans and specifications of the proposed sewage disposal- system have been reviewed and are considered satisfactory. Pernissi.on is hareby grained to tl:o or+ner or his agent to perform the work, indicated above in accordance with the Pitkin County IndiviJual Sewa;e Disposal Rc,nilations in effect on the date of issue. In addition to general provisions act forth on the reverse hercoi, this Permit is subject to t:he following additional terms and conditionsi14161NE r APPROVED FOR ISSUE BY Z - (title) The aboive individual sc•.:a,)o disposal system installed by Akwy (?^67ef1 _ w 0. _ i has been impacted for use by a representative of the Aipen I':t in Cnnvironciwttakliea t. oepartnant. The uwner asci—' u:'os ail rvnpons1biI1Ly in cdse of failure or inadequacy of thio sewage disposal system. Complete as -built drawing attached. c DATE- 0 FINAL I SP CT_ON' BY: - TITLE bM 130 South -Galena Street Aspen, Colorado 9'16'11 303/925-2020 ASPEI\I RITKIN ENVIRONMENTAL HEALTH DEPARTMENT APPLICATION FOR AN INDIVIDUAL SEWAGE DISPOSAL -PERMIT Name of OWNER Allan B. Iargolis PHONE 920-1194 Address of OWNER 0860 Buttermilk Weat - P .•0. Box 3102 - Aspen, Colorado ' Name of APPLICANT Meckley Company -James P eckley PHONE 927-3477 P£RMM/T TO BE: 'Xr—'cked Up ( ):Tailed toe . TYPE v:- PERMIT: i )New installation ( )Repair Owner ( )Applicant j )Emergency use Z)Alteration NOT due to failure LOCATION OF PROPOSED SYSTEM: Legal Description gLotBlockPilin Subdivision Size of Lot acres TYPE OF STRUCTURE: W Singh: Family Dwelling ( )Other: Do you plan any further additions to the residence? ( )YES "=N0 Co. of bedrooms_ No. 01` Lofts No, of Garbage Disposals No: of Automatic Dishwashers No. of Automatic Clothes Washers 1 WATER SUPPLY: (XPrivate Well, Depth or ( )Public, Name of System Spring Stream or Creek TYPES OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM PROPOSED: '. Septic Tank/Absorption Field ( )Aeration Plant/Absorption Field ( )Composting Toilet ( )Incineration Toilet ( )Mound Recycling, potable use ( )Recycling, other use ( )Vault Privy ( )Other: The initial site inspection must be arranged with the Aspen/Pitkin Environmental Health Department (925-2020. 9:30-9:30 a.m.) before a permit can be issued. The individual sewage disposal permit must be issued before a building permit can be obtained. FINAL INSPECTION APPROVAL MUST BE GIVEN BY THE ASPEN/PITKIN ENVIRONMENTAL HEALTH DEPARTMENT PRIOR TO BACKFILLING ANY PORTION of THE SYSTEM. ptrueand thatfalse taindividual any that the above information is t. Signature of Applicant DATE 7-26- 84 This application becomes. invalid 12 months from the above date.) NOTE: PLOT PLAN must be filed with this application. Please locate the following items by measured distances: 1. Property lines and dimensions. 2. Proposed and existing water wells on subject property and adjacent property. 3. Domestic water service lines. 4. Proposed and existing buildings, driveways, and other structures. S. Strears, lakes, ponds, irrigation ditches, and other water courses. 6. Proposed and existing individual sewage systems on subject property. , SUBMIT A REVISED PLOT PLAN PRIOR TO CONSTRUCTION IF INSTALLATION IS TO BE CHANGED FROM ORIGINAL PLAN. The undersigned hereby acknowledges receipt of this individual sewage disposal perrmi.t application and a permit feee0/ in the amount Receipt Number , Date Fee Received / ' / y by of S. /r•7`•- Administrative officer 130 South *Galena Street 'Aspen, Colorado +91611 303/925-2020 4OU5E 3 GIP t- cA 4` A ICA P QETVAI IIrG' ( CD1AAMMM ADPYt fi.t vJ IJS 111o, it . _ o SCA LX I DrVEWAY MT) 832‐R‐13‐002